title: Oral paricalcitol as antiproteinuric agent in chronic kidney disease.
abstract: BACKGROUND
  Vitamin D has an important regulatory effect on the renin-angiotensin-aldosterone system, playing a central role in the regulation of proteinuria. We therefore studied the antiproteinuric effect of paricalcitol.
  
  
  METHODS
  36 patients with an estimated GFR of 30-90 mL/min/1.73 m² and proteinuria >400 mg/d with a stable dose of ACE inhibitor or ARB for at least 3 months were recruited. Patients received oral paricalcitol 1 µg/day for 12 months. Primary endpoint was decrease in proteinuria from baseline. Secondary endpoints were changes in creatinine, eGFR, serum levels of calcium, phosphorus, iPTH, 25(OH)vitD, C-Reactive Protein and blood presure.
  
  
  RESULTS
  Mean proteinuria was 2806 mg/d and fell to 2199 mg/d at month 6 (p<.0001) and 1931.5 mg/d at month 12 (P<.0001). Patients with >3000 mg/d baseline proteinuria (n=12) saw smaller relative reductions in proteinuria (5956.9±2492.6 mg/d to 4220.4±2613 mg/d at 12 months) than patients with <3000 mg/d baseline proteinuria (1371±627.5 mg/d to 821.3±491.5mg/d at 12 months). There were no changes in BP, eGFR and CRP. We observed significant changes in serum levels of calcium, phosphorus, iPTH, 25(OH) vitamin D.
  
  
  CONCLUSIONS
  Our study shows an important reduction in proteinuria with a low dose of oral paricalcitol in CKD, that is particularly robust with baseline proteinuria between 1-3 g/d.
authors.forename: Alberto
authors.initials: A
authors.lastname: de Lorenzo
authors.forename: Laura
authors.initials: L
authors.lastname: Salanova
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Bomback
authors.forename: María
authors.initials: M
authors.lastname: Moya
authors.forename: Francisco
authors.initials: F
authors.lastname: Coronel
authors.forename: Carmen
authors.initials: C
authors.lastname: Bernis
authors.forename: José A
authors.initials: JA
authors.lastname: Sánchez-Tomero
authors.forename: Vicente
authors.initials: V
authors.lastname: Álvarez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002097:C-Reactive Protein / Q000032:analysis; D002118:Calcium / Q000097:blood; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D004872:Ergocalciferols / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011507:Proteinuria / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D004872:Ergocalciferols; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; C084656:paricalcitol; D002097:C-Reactive Protein; C104450:25-hydroxyvitamin D; D003404:Creatinine; D002118:Calcium